Under the Red Roof chronicles the rise and fall of an insane asylum in the frontier town of Sedro-Woolley, Washington. Northern State Hospital, as it came to be known, encompassed 1086 acres of sweeping mountain views, wild creeks and rich farmland, in a master designed landscape by John Charles Olmsted. A strong community existed among patients, doctors’ families, employees and townsfolk. The author gathered interviews from the switchboard operator, nurses, doctors, attendants, and families who had first-hand experience of the place. They described a unique inter-dependency between patients and staff whereby meaningful work contributed to a patient’s sense of belonging.In this 2020 updated version, the author includes new information and maps about the future plans for the site, made possible through a public/private collaboration, one that honors the hospital’s history, the Olmsted landscape legacy, and the public’s access to the land.